Clinical colorectal cancer最新文献

{"title":"Combination Treatment of Intratumoral Vidutolimod, Radiosurgery, Nivolumab, and Ipilimumab for Microsatellite Stable Colorectal Carcinoma With Liver Metastases","authors":"Ofer Margalit ,&nbsp;Sivan Lieberman ,&nbsp;Ilanit Redinsky ,&nbsp;Sharon Halparin ,&nbsp;Nir Honig ,&nbsp;Stephen Raskin ,&nbsp;Maoz Ben-Ayun ,&nbsp;Einat Shacham-Shmueli ,&nbsp;Naama Halpern ,&nbsp;Damien Urban ,&nbsp;Aliza Ackerstein ,&nbsp;Katerina Shulman ,&nbsp;Eytan Ben-Ami ,&nbsp;Valeriya Semenisty ,&nbsp;Ofer Purim ,&nbsp;Nirit Yarom ,&nbsp;Talia Golan ,&nbsp;Ben Boursi ,&nbsp;Sarit Appel ,&nbsp;Zvi Symon ,&nbsp;Yaacov R. Lawrence","doi":"10.1016/j.clcc.2023.08.004","DOIUrl":"10.1016/j.clcc.2023.08.004","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Microsatellite stable metastatic colorectal cancer (MSS mCRC) is largely refractory to immune checkpoint inhibition. We hypothesized that a combination of intratumoral </span>TLR9<span><span> agonist, radiosurgery and dual PD-1 and CTLA-4 blockade would induce a local focus of </span>immune stimulation, evoking a systemic immune response.</span></p></div><div><h3>Patients and Methods</h3><p><span>In this phase I single-institution study, patients with MSS mCRC were treated with a priming dose of s.c vidutolimod, 3 intratumoral injections of vidutolimod and radiosurgery, combined with </span>nivolumab<span> and ipilimumab. Cytokine levels were measured at baseline and at 7 (± 2) weeks. Patients were accrued to 4 consecutive cohorts: (1) Safety run-in without radiosurgery, (2) Radiosurgery prior to intratumoral therapy, (3) Radiosurgery prior to intratumoral therapy with a condensed timeline, and (4) Radiosurgery to extrahepatic lesion following completion of intratumoral therapy.</span></p></div><div><h3>Results</h3><p><span>A total of 19 patients were accrued. Median age was 59 years (range 40-71), 68% were male, median number of previous systemic treatments was 3 (range 2-5). None of the patients responded, aside from 1 patient, attributed to high tumor mutational burden. Grade 3 liver toxicity<span> was reported in 0%, 0%, 75%, and 17% in cohorts 1 to 4, respectively. Systemic levels of CXCL10 and IL-10 increased, with a median of 407 versus 78 pg/mL (</span></span><em>P</em> = .01), and 66 versus 40 pg/mL (<em>P</em> = .03), respectively.</p></div><div><h3>Conclusions</h3><p>The combination of intratumoral vidutolimod, radiosurgery, nivolumab and ipilimumab was not found to be efficacious in MSS mCRC with liver metastases. The juxtaposition of liver irradiation and intratumoral vidutolimod injection was associated with high hepatic toxicity.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10135741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety is Associated With Geriatric Assessment Impairments and Reduced Quality of Life Among Older Adults With Colorectal Cancer: Results From the CARE Registry","authors":"Daniel L. Hess ,&nbsp;Mackenzie E. Fowler ,&nbsp;Christian Harmon ,&nbsp;Smith Giri ,&nbsp;Grant R. Williams","doi":"10.1016/j.clcc.2023.08.001","DOIUrl":"10.1016/j.clcc.2023.08.001","url":null,"abstract":"<div><h3>Background</h3><p>Colorectal cancer (CRC) preferentially affects older adults. Modifiable factors, such as anxiety, can be measured as part of cancer-specific geriatric assessments (GA) completed prior to the start of treatment. We hypothesized that anxiety is prevalent among older adults with CRC and is associated with increased depression, increased frailty, and impaired health-related quality of life (HRQOL).</p></div><div><h3>Patients and Methods</h3><p>Patients ≥60 years old with newly diagnosed CRC completed a cancer-specific GA called the Cancer and Aging Resilience Evaluation (CARE). Between September 2017 and February 2023, we analyzed patients with CRC who had not yet received any systemic treatment. Anxiety was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety 4-item short form and reported as t-scores. We used modified Poisson models with robust variance estimation to assess for differences in the prevalence of depression, frailty, and impaired HRQOL.</p></div><div><h3>Results</h3><p>We analyzed 277 older adults with CRC. The median age of the study sample was 68 years. 57% were male, 72% were non-Hispanic White, and most had advanced CRC (35% stage III and 39% stage IV). Moderate/severe anxiety was present in 17% of older adults with newly diagnosed CRC. In adjusted models, as compared to patients without moderate/severe anxiety, patients with moderate/severe anxiety had significantly increased risk of depression (prevalence ratio [PR] 7.60, CI 4.90-11.78), frailty (PR 4.93, CI 3.01-8.07), impaired physical HRQOL (PR 3.57, CI 2.03-6.28), and impaired mental HRQOL (PR 3.82, CI 2.12-6.89).</p></div><div><h3>Conclusion</h3><p>Among older adults with CRC, anxiety is associated with increased depression and frailty as well as reduced HRQOL.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41143327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life After Colorectal Cancer: Survivorship the Road Less Traveled","authors":"Mehmet Sitki Copur","doi":"10.1016/j.clcc.2023.10.002","DOIUrl":"10.1016/j.clcc.2023.10.002","url":null,"abstract":"","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Next Best Thing: Three Key Conversations to Convey Prognosis Over the Course of an Incurable Cancer","authors":"Lindsay Gage,&nbsp;Melissa Teply","doi":"10.1016/j.clcc.2023.07.002","DOIUrl":"10.1016/j.clcc.2023.07.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Waiting until a person is very near end of life to discuss limited life expectancy risks lower goal-concordant care and increased utilization of medical interventions with lower likelihood of benefit at the end of life. Medical training on communication skills in serious illness often focuses on early and late conversations regarding prognosis, with no guidance on navigating the conversations occurring in the middle of the illness course.</p></div><div><h3>Goal of the review</h3><p>We propose a new framework for identifying and discussing prognosis at various points along the cancer course, as a continuum from beginning to end, that is prompted by changes in clinical status and number of available remaining cancer directed interventions.</p></div><div><h3>Discussion</h3><p>SPIKES is a framework utilized for early conversations in a cancer course. REMAP is a framework utilization for late conversations in a cancer course. There is a gap in guidance on how to navigate conversations that occur between the early and late phases of a cancer course. We describe 3 general phases of care during a cancer course (“early,” “middle,” and “late”), with each phase warranting specific communication skills in order to improve patient understanding of prognosis, goal concordant care, and best practices for healthcare utilization in the acute and end of life care settings.</p></div><div><h3>Conclusion</h3><p>Framing prognosis by available medical interventions through a framework of “early,” “middle,” and “late” adds clarity to the phase of illness, expectations around delivery of information to the patient, and framing of recommendations at each given phase.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10246338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes Following Recent and Distant Neoadjuvant Radiation in Rectal Cancer: An Institutional Retrospective Review and Analysis of NSQIP","authors":"Kevin Arndt,&nbsp;Ana Sofia Ore,&nbsp;Jeanne Quinn,&nbsp;Anne Fabrizio ,&nbsp;Kristen Crowell,&nbsp;Evangelos Messaris,&nbsp;Thomas Cataldo","doi":"10.1016/j.clcc.2023.07.006","DOIUrl":"10.1016/j.clcc.2023.07.006","url":null,"abstract":"<div><h3>Background</h3><p>Neoadjuvant chemoradiotherapy<span><span> (nCRT) is the standard of care in locally advanced rectal cancer (LARC). However, radiation therapy is thought to increase operative difficulty due to induction of fibrosis. Total </span>neoadjuvant therapy (TNT) protocols increase the time between completion of radiation and surgical resection which may lead to increased operative difficulty and complications.</span></p></div><div><h3>Methods</h3><p>A single institution retrospective review of patients ≥18 years with LARC undergoing nCRT from 2015 to 2022. Patients were dichotomized in 2 cohorts: &lt;90 days from radiation to surgery (recent radiation), and ≥90 days from radiation to surgery (distant radiation). Institutional data was compared to National Surgical Quality Improvement Program (NSQIP) rectal cancer data from 2016 to 2020. Outcomes included intraoperative complications, 30-day morbidity, and oncologic outcomes.</p></div><div><h3>Results</h3><p>One hundred forty-six institutional patients included, 120 had recent radiation, 26 had distant radiation. Thirty-day morbidity and intraoperative complications did not differ. There was greater radial margin positivity (7% vs. 24%), fewer lymph nodes harvested (17 ± 5 vs. 15 ± 6), and a lower rate of complete mesorectal dissection (88% vs. 65%,) in distant radiation patients 3059 patients were included in NSQIP analysis, 2029 completed radiation &lt;90 days before surgery and 1030 without radiation 90 days before surgery. Patients without radiation 90 days preoperatively had more radial margin positivity (9.2% vs. 4.6%), organ space infection (8.6% vs. 6.4%), and pneumonia (2.2% vs. 0.9%).</p></div><div><h3>Conclusion</h3><p>The present study suggests that increased time between radiation and surgery results in more challenging dissection with less complete mesorectal dissection and increased radial margin positivity without increasing technical complications.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49686377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Cetuximab Concentrations Correlate With Survival in Patients With Advanced KRAS Wild Type Colorectal Cancer","authors":"Di Maria Jiang ,&nbsp;Shruti Parshad ,&nbsp;Luna Zhan ,&nbsp;Hao-Wen Sim ,&nbsp;Lillian L. Siu ,&nbsp;Geoffrey Liu ,&nbsp;Jeremy D. Shapiro ,&nbsp;Timothy J. Price ,&nbsp;Derek J. Jonker ,&nbsp;Christos S. Karapetis ,&nbsp;Andrew H. Strickland ,&nbsp;Wenjiang Zhang ,&nbsp;Mark Jeffery ,&nbsp;Dongsheng Tu ,&nbsp;Siobhan Ng ,&nbsp;Sabe Sabesan ,&nbsp;Jenny Shannon ,&nbsp;Amanda Townsend ,&nbsp;Chris J. O'Callaghan ,&nbsp;Eric X. Chen","doi":"10.1016/j.clcc.2023.08.006","DOIUrl":"10.1016/j.clcc.2023.08.006","url":null,"abstract":"<div><h3>Background</h3><p>Cetuximab is a standard of care therapy for patients with RAS wild-type (WT) advanced colorectal cancer. Limited data suggest a wide variation in cetuximab plasma concentrations after standard dosing regimens. We correlated cetuximab plasma concentrations with survival and toxicity.</p></div><div><h3>Methods</h3><p>The CO. 20 study randomized patients with RAS WT advanced colorectal cancer in a 1:1 ratio to cetuximab 400 mg/m² intravenously followed by weekly maintenance of 250 mg/m², plus brivanib 800 mg orally daily or placebo. Blood samples obtained at week 5 precetuximab treatment were analyzed by ELISA. Patients were grouped into tertiles based on plasma cetuximab concentrations. Cetuximab concentration tertiles were correlated with survival outcomes and toxicity. Patient demographic and biochemical parameters were evaluated as co-variables.</p></div><div><h3>Results</h3><p>Week 5 plasma cetuximab concentrations were available for 591 patients (78.8%). The median overall survival (OS) was 11.4 months and 7.8 months for patients in the highest (T3) and lowest tertiles (T1) respectively. On multivariable analysis, plasma cetuximab concentration was associated with OS (HR 0.66, 95% confidence interval [CI]: 0.53-0.83, <em>P</em> &lt; .001, T3 vs. T1), and a trend towards progression-free survival (HR 0.82, 95% CI: 0.66-1.02, <em>P</em> = .07, T3 vs. T1). There was no association between cetuximab concentration and skin toxicity or diarrhea.</p></div><div><h3>Conclusion</h3><p>The standard cetuximab dosing regimen may not be optimal for all patients. Further pharmacokinetic studies are needed to optimize cetuximab dosing given the potential improvement in OS.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1533002823000841/pdfft?md5=e0a41a9a60e704490112f06409d6077d&pid=1-s2.0-S1533002823000841-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10233316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance of Feasibility Assessment in the Design of ctDNA Guided Trials – Results From the OPTIPAL II Study","authors":"Louise Bach Callesen ,&nbsp;Anders Kindberg Boysen ,&nbsp;Christina Søs Auður Andersen ,&nbsp;Niels Pallisgaard ,&nbsp;Karen-Lise Garm Spindler","doi":"10.1016/j.clcc.2023.07.005","DOIUrl":"10.1016/j.clcc.2023.07.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Both quantitative and molecular changes in ctDNA can hold important information when treating metastatic colorectal cancer (mCRC), but its clinical utility is yet to be established. Before conducting a large-scale randomized trial, it is essential to test feasibility. This study investigates whether ctDNA is feasible for detecting patients who will benefit from treatment with epidermal growth factor receptor inhibitors and the prognostic value of circulating tumor DNA (ctDNA) response.</p></div><div><h3>Materials and methods</h3><p>Patients with mCRC, who were considered for systemic palliative treatment and were eligible for ctDNA analysis. Mutational testing on cell-free DNA (cfDNA) was done by ddPCR. ctDNA response from baseline to the third treatment cycle was evaluated in patients with detectable ctDNA at baseline. ctDNA maximum response was defined as undetectable ctDNA at the third treatment cycle, ctDNA partial response as any decrease in the ctDNA level, and ctDNA progression as any increase in the ctDNA level.</p></div><div><h3>Results</h3><p>Forty-nine patients were included. The time to test results for mutational testing on cfDNA was significantly shorter than on tumor tissue (<em>p</em> &lt; .001). Progression-free survival were 11.2 months (reference group), 7.5 months (HR = 10.7, <em>p</em>= .02), and 4.6 months (HR = 11.4, <em>p</em>= .02) in patients with ctDNA maximum response, partial response, and progression, respectively. Overall survival was 31.2 months (reference group), 15.2 months (HR = 4.1, <em>p</em>= .03), and 9.0 months (HR = 2.6, <em>p</em>= .03) in patients with ctDNA maximum response, partial response, and progression, respectively.</p></div><div><h3>Conclusion</h3><p>Pretreatment mutational testing on cfDNA in daily clinic is feasible and can be applied in randomized clinical trials evaluating the clinical utility of ctDNA. Early dynamics in ctDNA during systemic treatment hold prognostic value.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1533002823000646/pdfft?md5=a4efabfb35ea44f63ae0be8cc3a8eae0&pid=1-s2.0-S1533002823000646-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10389343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic Body Radiotherapy for Management of Pulmonary Oligometastases in Stage IV Colorectal Cancer: A Perspective","authors":"Michael X. Fu ,&nbsp;Catarina Carvalho ,&nbsp;Bella Milan-Chhatrisha ,&nbsp;Nishita Gadi","doi":"10.1016/j.clcc.2023.09.001","DOIUrl":"10.1016/j.clcc.2023.09.001","url":null,"abstract":"<div><p><span>In pulmonary oligometastases from colorectal cancer (POM-CRC), metastasectomy<span><span> is the primarily recommended treatment. </span>Stereotactic body radiotherapy (SBRT) has been suggested as a viable alternative therapy. SBRT efficacy for POM-CRC is poorly delineated compared to selected non-CRC primaries. This perspective article aims to critically summarize the existing evidence regarding efficacy of SBRT in terms of overall survival (OS) and local control (LC), and factors modulating this, in the treatment of POM-CRC. Overall, reasonable LC and OS rates were observed. The wide range of expansions in planning target volume margins introduced variation in pretreatment protocols. Dose-fractionation schedules varied according to patient and tumor characteristics, though leverage of BED</span></span>₁₀<span><span> in select studies enabled standardization. An association between SBRT dose and improved OS and LC was observed across multiple studies. Prognostic factors that were associated with improved LC included: fewer oligometastases, absence of extra-pulmonary metastases, primary </span>tumor histology<span>, and smaller gross tumor volume. Differences in SBRT modality and techniques over time further confounded results. Many studies included patients receiving additional systemic therapies; preprotocol and adjuvant chemotherapies were identified as prognostic factors for LC. SBRT compared with metastasectomy showed no differences in short-term OS and LC outcomes. In conclusion, SBRT is an efficacious treatment for POM-CRC, in terms of OS and LC. Heterogeneity in study design, particularly pertaining to dose protocols, patient selection, and additional therapies should be controlled for future randomized studies to further validate SBRT efficacy.</span></span></p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41176272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-VEGF Therapy Possibly Extends Survival in Patients With Colorectal Brain Metastasis by Protecting Patients From Neurologic Disability","authors":"Chih-Wen Chen ,&nbsp;Tao-Shen Ou ,&nbsp;Wei-Shone Chen ,&nbsp;Jeng-Kai Jiang ,&nbsp;Shung-Haur Yang ,&nbsp;Huann-Sheng Wang ,&nbsp;Shih-Ching Chang ,&nbsp;Yuan-Tzu Lan ,&nbsp;Chun-Chi Lin ,&nbsp;Hung-Hsin Lin ,&nbsp;Sheng-Chieh Huang ,&nbsp;Hou-Hsuan Cheng ,&nbsp;Yi-Wen Yang ,&nbsp;Yu-Zu Lin ,&nbsp;Yee Chao ,&nbsp;Ling-Wei Wang ,&nbsp;Hao-Wei Teng","doi":"10.1016/j.clcc.2023.03.003","DOIUrl":"10.1016/j.clcc.2023.03.003","url":null,"abstract":"<div><h3>Background</h3><p>Colorectal brain metastases (CBMs) are rare with poor prognosis. There is still no standard systemic treatment for multiple or unresectable CBM. our study aimed to explore the impact of anti-VEGF therapy on overall survival, brain-specific disease control, and neurologic symptom burden in patients with CBM<em>.</em></p></div><div><h3>Methods</h3><p>A total of 65 patients with CBM under treatment were retrospectively enrolled and divided into anti-VEGF based systemic therapy or non–anti-VEGF based therapy. A total of 25 patients who received at least 3 cycles of anti-VEGF agent and 40 patients without anti-VEGF therapy were analyzed by endpoints of overall survival (OS), progression-free survival (PFS), intracranial PFS (iPFS) and neurogenic event-free survival (nEFS)<strong><em>.</em></strong> Gene expression in paired primary metastatic colorectal cancer (mCRC), liver, lung and brain metastasis from NCBI data was analyzed using top Gene Ontology (GO) and cBioPortal.</p></div><div><h3>Results</h3><p>Patients who treated with anti-VEGF therapy had significantly longer OS (19.5 vs. 5.5 months, <em>P</em> = .009), iPFS (14.6 vs. 4.1 months, <em>P</em> &lt; .001) and nEFS (17.6 vs. 4.4 months, <em>P</em> &lt; .001). Patients who received anti-VEGF therapy beyond any disease progression presented with superior OS (19.7 vs. 9.4 months, <em>P</em> = .039). Top GO and cBioPortal analysis revealed a stronger molecular function of angiogenesis in intracranial metastasis.</p></div><div><h3>Conclusions</h3><p>Anti-VEGF based systemic therapy showed favorable efficacy that was reflected in longer overall survival, iPFS and NEFS in patients with CBM.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10118402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Efficacy of Targeted Monoclonal Antibodies in Left-Sided Colon and Rectal Metastatic Cancers","authors":"Hiroyuki Kodama,&nbsp;Toshiki Masuishi,&nbsp;Munehiro Wakabayashi,&nbsp;Akinobu Nakata,&nbsp;Ryosuke Kumanishi,&nbsp;Taiko Nakazawa,&nbsp;Takatsugu Ogata,&nbsp;Yuki Matsubara,&nbsp;Kazunori Honda,&nbsp;Yukiya Narita,&nbsp;Hiroya Taniguchi,&nbsp;Shigenori Kadowaki,&nbsp;Masashi Ando,&nbsp;Kei Muro","doi":"10.1016/j.clcc.2023.05.002","DOIUrl":"10.1016/j.clcc.2023.05.002","url":null,"abstract":"<div><h3>Background</h3><p>The recommended first-line chemotherapy for <em>RAS/BRAF</em> wild-type metastatic colorectal cancer (mCRC) is bevacizumab (BEV)-containing therapy for right-sided colon cancer (R) and antiepidermal growth factor receptor antibody (anti-EGFR)-containing therapy for left-sided colon cancer (L) or rectal cancer (RE). However, anatomical or biological heterogeneity reportedly exists between L and RE. Therefore, we aimed to compare the efficacies of anti-EGFR and BEV therapies for L and RE, respectively.</p></div><div><h3>Methods</h3><p>We retrospectively reviewed 265 patients with <em>KRAS (RAS</em>)/<em>BRAF</em> wild-type mCRC treated with fluoropyrimidine-based doublet chemotherapy plus anti-EGFR or BEV as the first-line treatment at a single institution. They were divided into 3 groups: R, L, and RE. Overall survival (OS), progression-free survival (PFS), objective response rate, and conversion surgery rate were analyzed.</p></div><div><h3>Results</h3><p>Forty-five patients had R (anti-EGFR/BEV: 6/39), 137 patients had L (45/92), and 83 patients had RE (25/58). In patients with R, both median (m) PFS and OS were superior with BEV therapy (mPFS, anti-EGFR vs. BEV: 8.7 vs. 13.0 months, hazard ratio [HR]: 3.90, <em>P</em> = .01; mOS, 17.1 vs. 33.9 months, HR: 1.54, <em>P</em> = .38). In patients with L, better mPFS and comparable mOS with anti-EGFR therapy were observed (mPFS, 20.0 vs. 13.4 months, HR: 0.68, <em>P</em> = .08; mOS, 44.8 vs. 36.0 months, HR: 0.87, <em>P</em> = .53), whereas, in patients with RE, comparable mPFS and worse mOS with anti-EGFR therapy were observed (mPFS, 17.2 vs. 17.8 months, HR: 1.08, <em>P</em> = .81; mOS, 29.1 vs. 42.2 months, HR: 1.53, <em>P</em> = .17).</p></div><div><h3>Conclusions</h3><p>Efficacies of anti-EGFR and BEV therapies may differ between patients with L and RE.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10114109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}